My newborn’s skin looks yellow. Is it jaundice?

If your newborn’s skin develops a yellowish tinge a few days after birth, this means she has jaundice. If your baby has dark skin you are more likely to notice a yellow tinge to the white of her eyes, the palms of her hands or soles of her feet. See a photo of jaundice in our rashes and skin conditions gallery.

Jaundice affects over half of all healthy babies in the first few days of life. It is also very common among premature babies (NICE 2010).

If your baby was born full term it will usually take up to a week for her skin and eye colour to return to normal. It may take a bit longer if she was premature or if you're breastfeeding.

Jaundice is usually nothing to worry about. But you should mention it to your paediatrician as soon as you notice it. Occasionally jaundice may be more serious and need treatment straight away.

What causes jaundice?

Jaundice develops in a healthy baby when the blood contains an excess of bilirubin - a chemical produced during the normal breakdown of old red blood cells. Newborns tend to have higher levels because they have extra oxygen-carrying red blood cells and their young livers can't metabolise the excess bilirubin. As bilirubin levels rise above normal, the yellowness of jaundice moves downwards from head, to neck, then chest, until, in severe cases, it finally reaches the toes.

So-called physiological jaundice (unlike the rare, more serious version caused by liver disease or rhesus disease) usually causes no damage in healthy full-term infants.

In very rare instances, jaundiced newborns may suffer damage to the nervous system - but only when bilirubin levels are extremely elevated.

How can I tell if my baby has jaundice?

Experts recommend this quick home test to check for jaundice. In a well-lit room, apply gentle pressure to your baby's nose or forehead; if there's a yellow tinge to the skin as the pressure is released, consult your paediatrician. This technique works best for fair-skinned children; if your baby has dark skin check for yellowness in the whites of the eyes or gums. You may also notice that your baby has very pale poo.

Jaundice is very common and is usually a temporary condition which clears up quickly without any intervention and has no long-term effects. You can ask your paediatrician for help at any time if you are concerned.

How will my baby's jaundice be treated?

If your baby is breastfed you should breastfeed her frequently. You may need to wake your baby to feed if she is very sleepy. She should not normally be given any other fluids such as formula milk or water as frequent breastfeeding will help clear the jaundice.

If your baby is very jaundiced or is unwell, your doctor may give your baby a blood test to measure her bilirubin levels. The doctor will also need to look into what is causing the jaundice if it starts after seven days or lasts longer than 14 days.

Some babies might need additional treatment, usually phototherapy. Your baby will need to be in hospital and will have a blue light over her bed. The light helps break down the excess bilirubin so that the liver can get rid of it. Side effects from the phototherapy include rashes and diarrhoea but it is very important that the excess bilirubin is broken down. This is usually done in the hospital’s baby nursery.

An alternative to traditional phototherapy is fibre optic therapy. Your baby will be wrapped in a special blanket which has fibre optics, little lights that shine directly onto her skin. You can still cuddle and feed your baby. Fibre optic treatment is not as effective as traditional phototherapy for full-term babies. Furthermore, from local experience, fibre optic treatment can sometimes overheat premature babies. Fibre optic treatment, used together with traditional phototherapy, is considered the most effective treatment for jaundice in newborns.

Sometimes jaundice is caused by an infection and this might need to be treated.

If your baby has rhesus disease this may cause jaundice. This is extremely rare. Pregnant women routinely have their blood type checked to prevent this, and if you are rhesus negative you will almost certainly know this. Your baby's blood will also have been checked and anti-D injections will have been offered at birth. In the extremely unlikely event of your baby developing jaundice as a result of rhesus disease your baby may need a blood transfusion.

Is jaundice ever dangerous?

Yes, it can be. Never take jaundice lightly. Studies have shown that if the bilirubin exceeds a certain level, then your baby’s hearing may be affected. At very high levels, the brain may also be affected and when this occurs, it is called kernicterus.

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